Suprapubic transcatheter prostate enucleation is a more mature surgical technique with the advantages of easy mastery, definitive results, and few complications such as urinary incontinence and sexual dysfunction. The disadvantages are that it is highly invasive, bleeding, and not suitable for smaller patients with severe fibrosis. In comparison with TURP, mature TURP surgeons should have more than 50 cases of TURP surgery experience, long learning curve, possible permanent incontinence, impotence and residual gland with hyperplasia as disadvantages, but suitable for all patients with prostate enlargement requiring surgical treatment due to less trauma, as well as the emergence of more energy platforms in recent years, such as laser or plasma electrokinetic prostatectomy, which The trend is to gradually replace open suprapubic transcatheter prostatectomy, but because of the inherent advantages of suprapubic transcatheter prostatectomy, urologists should be skilled in this procedure and should not abandon it. The following are some of the considerations for this procedure: 1. Position Supine, with the buttocks elevated and legs slightly apart. The purpose of the hip pad is to make the prostate and prostate fossa relatively superficial and easy to operate; the purpose of the legs slightly apart is that if it is difficult to remove the prostate during the operation, the surgeon can put the finger of the left hand into the anus and lift the prostate forward and upward to make the removal of the prostate easier and to prevent rectal injury. 2. incision A median incision is made in the lower abdomen, with the lower part of the incision crossing the pubic bone to better expose the bladder neck. (Figure 1) 3. Longitudinal incision of the bladder to the bladder neck and prostate junction reveals the prostate, where the prostatic vein continues from the bladder and can be closed with intestinal sutures if bleeding. 4. Expose and remove the prostate gland. Pull open the bladder incision with a deep abdominal pulling hook, paying attention to the position of the bilateral ureteral orifices to prevent damage to the ureteral orifices when suturing the bladder neck during surgery. The mucosa at the junction of the prostate and bladder is incised with an electric knife to prevent tearing of the mucosa of the bladder neck when removing the prostate. When separating the urethra at the front of the prostate, the urethra should be broken or pinched off at the tip of the prostate, and the mucous membrane of the urethra should not be torn off in large pieces to avoid postoperative urethral stricture or urinary incontinence. 5. Suture hemostasis At 4 and 8 points, use Alice clamp and lift upward (Figure 2), one-half arc suture needle gut line depth and span is greater than about 1 cm 8 word suture hemostasis, do not advocate continuous suture at 4 to 8 points, this suture may appear bladder neck contracture and stenosis, bladder neck large span suture to reduce the bladder neck opening, bladder neck opening can be 2 to 3 cross fingers (Figure 3). 6. Retained balloon urinary catheter: The balloon of the urinary catheter is retained in the bladder (Figure 4), the purpose of which is to isolate the bladder from the prostatic fossa after stretching to reach the prostatic fossa to restrict bleeding in the prostatic fossa and make the prostatic fossa contract. If the balloon is applied to compress the prostatic fossa, there may be bleeding from the bladder neck and irregularities in the prostatic fossa pattern with unequal pressure in various areas and insufficient pressure in some areas.